Wednesday, September 23, 2009

Dr. Kostroff

I had my appointment with Dr. Kostroff. She was very nice and answered all my questions. Since she is the 4th breast surgeon I have seen I am getting pretty good at knowing what to ask. She can do the surgery on October 9th. She works with Dr. Keller all the time and it sounds like they have a pretty good system down. She looked at all my films and she said she will send my biopsy slides to LIJ.

She agrees with my decision to do a double mastectomy. She feels that the family history is so strong that it makes the risk high enough to justify it. She will do the sentinal biopsy on both sides. When I said I was concerned about my arms being hyper extended during the surgery she said that they are doing special things to reduce the risk of injury during the surgery. They will check for position of comfort and move my arms and legs during the surgery to reduce any injury from lack of movement or weird positioning. All good.

She said she can set me up with an oncologist who does strictly breast oncology and is on my insurance plan. That is great and I did not know there were even oncologists who worked with only breast cancer patients.

Now we get to the money. Always an issue. She doesn't take any insurance. I spoke to her financial person. She said my part of it would be $10, 500. I said I didn't think I could use Dr. Kostroff and would have to keep looking for someone on my plan. I am a little on the edge and PMSing on top of it so I just started crying. Dr. Kostfroff was nearby and said to come in her office.

When I went into Dr. Kostroff's office I explained the whole Julianna birth story to her. I said I had great insurance and was using an OB on my plan. Then, I got preeclampsia and HELLP syndrome. It led to kidney, liver and heart failure. I had severe cerebral edema and was going into DIC. They did an emergency c-section. The surgeon wasn't on my plan. The anesthesiologist, not on the plan. The sent in a hematologist, GI doctor, kidney specialist, neurologist, opthamologist, cardiologist, pulmonologist, family practice and on and on. As far as Julianna, the neonatologist, not on the plan and $1500 a shift, times 16 days. All in all, I am very happy we are both alive, but it was almost $60,000 by the time it was over, and that was just my 20%. Everything I had saved over 20 years was gone in 16 days. It is still not paid. So, here we are with catastrophic medical event number two in less than two years. I explained to her that I can't do it. She said she understood and agreed to take whatever the insurance paid her. I thought that was really nice and a HUGE relief to me.

Its funny, with the huge debate about healthcare these days I hear so many people saying how great their personal insurance plan is. I say get back to me on that after you have a catostrophic medical event. Just because you think everything is covered doesn't mean it is. The doctors who see you in the hospital bill separately from the hospital. I was covered for the hospital. If you need specialists, and you never know, you are probablly not covered for them all. Even with good insurance you are probablly responsible for 20% of the bill for those not on your plan. Let me tell you it will not take long to add up big. I do not really know anything about the current plan being proposed, but I can tell you that something really needs to change.

So I am happy about her working with me on the financial end. I really liked her and it sounds good. They said they would call me back tomorrow to confirm the date for 10/9.

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